[Surgical treatment for trigeminal neuralgia]

We treated 50 patients at the Hospital de Especialidades, Centro Médico Nacional La Raza, IMSS, in Mexico City, with trigeminal neuralgia by two procedures: a) microvascular decompression of the trigeminal nerve with asterional craniectomy, or b) compression of Gasser's nodule by percutaneous puncture. Each patient was allowed to choose one of the procedures after informed consent. Twenty two patients underwent percutaneous puncture, while 28 patients underwent microvascular decompression. Our study group comprised 35 females and 15 males between the ages of 38 and 80 years. After 3 months, we achieved good-to-excellent results in 25 patients with microvascular decompression and in 15 patients, with compression of Gasser's nodule. At 2 years follow-up, our results remained the same for microvascular decompression group while in the other group we observed only satisfactory results in 59% of cases. In craniectomy group, we found vascular compression in 96% of cases. Five patients presented hypoacusia after decompressive procedure and eight patients had facial dysesthesia after percutaneous procedure. In percutaneous group, procedures were cancelled due to technical difficulties in two cases. We conclude that both procedures are safe, with zero mortality. The microvascular procedure affords better results at 2 years follow-up.